Effects of Positive HIV Status Disclosure on Sexual Behaviour Change

Introduction: Disclosure of HIV serostatus is critical to controlling the spread of HIV, and understanding the experience for disclosure enhances the development of prevention interventions and ultimately leads to better control of the spread of the disease. The present narrative review aimed to synthesize literature on the effects of positive HIV status disclosure on sexual behaviour change. Method: A narrative review design was utilized. Literature search of articles was from the following databases; Scopus, Science Direct, PUBMED, OVID and Google scholar. The searches were conducted from August 2019 to June 2020. The qualitative analysis was used to presented data into themes. Results: The main findings were discussed under four thematic domains: 1) disclosure, 2) number of sexual partners, 3) type of sexual partners and 4) use condoms. Conclusion: The narrative review presents evidence on; how patients revealing their HIV positive status to their sexual partner(s), family members, or others in their social circle are associated to better, less risky sexual behaviors. This finding implies that when people living with HIV disclose their status, they are most likely to; 1) have less sexual partners, 2) use condoms and 3) minimize casual/temporary sex. The behavior change brought by the positive HIV status disclosure can significantly reduce the transmission of HIV within the society.College of Human Science

Neonatal mortality in Kenyan hospitals: a multisite, retrospective, cohort study

Background Most of the deaths among neonates in low-income and middle-income countries (LMICs) can be prevented through universal access to basic high-quality health services including essential facility-based inpatient care. However, poor routine data undermines data-informed efforts to monitor and promote improvements in the quality of newborn care across hospitals.Methods Continuously collected routine patients’ data from structured paper record forms for all admissions to newborn units (NBUs) from 16 purposively selected Kenyan public hospitals that are part of a clinical information network were analysed together with data from all paediatric admissions ages 0–13 years from 14 of these hospitals. Data are used to show the proportion of all admissions and deaths in the neonatal age group and examine morbidity and mortality patterns, stratified by birth weight, and their variation across hospitals.Findings During the 354 hospital months study period, 90 222 patients were admitted to the 14 hospitals contributing NBU and general paediatric ward data. 46% of all the admissions were neonates (aged 0–28 days), but they accounted for 66% of the deaths in the age group 0–13 years. 41 657 inborn neonates were admitted in the NBUs across the 16 hospitals during the study period. 4266/41 657 died giving a crude mortality rate of 10.2% (95% CI 9.97% to 10.55%), with 60% of these deaths occurring on the first-day of admission. Intrapartum-related complications was the single most common diagnosis among the neonates with birth weight of 2000 g or more who died. A threefold variation in mortality across hospitals was observed for birth weight categories 1000–1499 g and 1500–1999 g.Interpretation The high proportion of neonatal deaths in hospitals may reflect changing patterns of childhood mortality. Majority of newborns died of preventable causes (>95%). Despite availability of high-impact low-cost interventions, hospitals have high and very variable mortality proportions after stratification by birth weight